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Luiz de Macedo Fariashttp://lattes.cnpq.br/3041207015099007Paula Prazeres Magalhãeshttp://lattes.cnpq.br/2184773662680617Simone Gonçalves Santos-KeyNatália Rocha Guimarãeshttp://lattes.cnpq.br/6750521023222229Cássia Lopes Silva2024-02-27T15:38:18Z2024-02-27T15:38:18Z2021-08-27http://hdl.handle.net/1843/64785A introdução dos antimicrobianos, na década de 1930, revolucionou a prática médica e promoveu avanços na abordagem terapêutica de pacientes com doenças infecciosas. A princípio, imaginava-se que eles seriam uma solução absolutamente efetiva, que proporcionaria a cura destes pacientes, controlando doenças que, até então, dizimavam populações. Contudo, logo se percebeu que o emprego desses fármacos poderia promover um efeito indesejado, qual seja a seleção de amostras resistentes aos mesmos, problemática cada vez mais preocupante. Entre os locais que mais favorecem a disseminação da resistência aos antimicrobianos, merecem menção os ambientes relacionados à assistência à saúde. Dentre os microrganismos de relevância clínica atual, destacam-se os bastonetes Gram- negativos não fermentadores, entre eles, Acinetobacter baumannii, Pseudomonas aeruginosa e Stenotrophomonas maltophilia. Este estudo visa à avaliação fenotípica e genotípica da resistência a antimicrobianos de amostras de A. baumannii, P. aeruginosa e S. maltophilia isoladas de pacientes hospitalizados, respectivamente. Os perfis fenotípico e genotípico de resistência foram avaliados por disco-difusão e reação de polimerização em cadeia. Os resultados obtidos para as amostras de A. baumannii revelaram percentuais de resistência a antimicrobianos bem elevados. Destaca-se a resistência aos β-lactâmicos, superiora 80%, fármacos mais comumente utilizados. Detectou-se também, com frequência, genes que codificam resistência a este grupo de antimicrobianos, como blaOXA-23, blaKPC, blaVIM e blaOXA-143. P. aeruginosa apresentou percentuais de resistência fenotípica menores, variando entre 10 e 34%, mas que ainda despertam preocupação. Nas amostras da espécie, foram observados os marcadores genéticos aac(6’)-Ib-cr, blaBEL-1, blaCTX-M, blaGES, blaKPC-2, blaSHV e blaVIM. Já S. maltophilia apresentou uma amostra resistente aos dois antimicrobianos testados e nenhum marcador de resistência, em contrapartida às outras três amostras do microrganismo que, embora tenham se mostrado sensíveis no antibiograma, albergavam marcadores genéticos relacionados à resistência a antimicrobianos. O estudo da resistência bacteriana a fármacos antimicrobianos e dos mecanismos relacionados à expressão da característica são uma ferramenta importante para subsidiar o delineamento de estratégias visando ao controle da evolução das taxas de resistência, minimizando as repercussões dessa propriedade.The introduction of antimicrobials in the 1930s revolutionized medical practice and promoted advances in therapeutic approach to patients with infectious diseases. Originally, it was thought that they would be an absolutely effective solution, providing the cure for these patients, controlling diseases that, until then, had decimated populations. However, it was soon realized that the use of these drugs could promoted an unwanted effect, namely the selection of samples resistant to them, an increasingly worrying conundrum. Among the sites that most favor the spread of antimicrobial resistance, the environments related to health care deserve mention. Among the microorganisms of current clinical relevance, the non-fermenting Gram-negative rods stand out, including Acinetobacter baumannii, Pseudomonas aeruginosa and Stenotrophomonas maltophilia, respectively. This study aims at the phenotypic and genotypic evaluation of antimicrobial resistance in samples of A. baumannii, P. aeruginosa and S. maltophilia sampled from hospitalized patients. The phenotypic and genotypic resistance profiles were evaluated by disk diffusion and polymerase chain reaction. The results obtained for the samples of A. baumannii revealed high percentages of resistance to antimicrobials. β-lactams resistance, the most commonly used drugs, stood out as higher than 80%. Genes that encode resistance to this group of antimicrobials, such as blaOXA-23, blaKPC, blaVIM and blaOXA-143, were also frequently detected. P. aeruginosa showed lower percentages of phenotypic resistance, ranging between 10 and 34%, but that still arouse concern. In samples of these species, the genetic markers aac (6’)-Ib-cr, blaBEL-1, blaCTX-M, blaGES, blaKPC-2, blaSHV and blaVIM were observed. Contrastingly, S. maltophilia presented a sample resistant to the two tested antimicrobials and no resistance marker, in contrast to the other three samples of the microorganism which, although were shown to be sensitive in the antibiogram, harbored genetic markers related to resistance to antimicrobials. The study of bacterialresistance to antimicrobial drugs and mechanisms related to the expression of the trait are an important tool to support the design of strategies aimed at controlling the evolution of resistance rates, minimizing the repercussions of this property.CNPq - Conselho Nacional de Desenvolvimento Científico e TecnológicoporUniversidade Federal de Minas GeraisPrograma de Pós-Graduação em MicrobiologiaUFMGBrasilICB - DEPARTAMENTO DE MICROBIOLOGIAMicrobiologiaResistência Microbiana a MedicamentosAcinetobacter baumanniiPseudomonas aeruginosaStenotrophomonas maltophiliaResistência a antimicrobianosAcinetobacter baumanniiPseudomonas aeruginosaStenotrophomonas maltophiliaAvaliação fenotípica e genotípica da resistência a fármacos antimicrobianos de bastonetes Gram- negativos não fermentadores isolados de espécimes clínicos hospitalaresPhenotypic and genotypic evaluation of resistance to antimicrobial drugs in non-fermenting Gram-negative rods isolated from hospital clinical specimensinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGORIGINALDissertação Cássia Lopes -corrigido.pdfDissertação Cássia Lopes -corrigido.pdfapplication/pdf1886484https://repositorio.ufmg.br/bitstream/1843/64785/3/Disserta%c3%a7%c3%a3o%20C%c3%a1ssia%20Lopes%20-corrigido.pdf4cc523f3ca85c45f1622f052395214b5MD53LICENSElicense.txtlicense.txttext/plain; charset=utf-82118https://repositorio.ufmg.br/bitstream/1843/64785/4/license.txtcda590c95a0b51b4d15f60c9642ca272MD541843/647852024-02-27 12:38:18.754oai:repositorio.ufmg.br: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ório InstitucionalPUBhttps://repositorio.ufmg.br/oaiopendoar:2024-02-27T15:38:18Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false
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